Gastric emptying during and following resolution of moderate diabetic ketoacidosis in type 1 diabetes: a case series

BMJ Open Diabetes Res Care. 2024 Apr 3;12(2):e003854. doi: 10.1136/bmjdrc-2023-003854.

Abstract

Introduction: To use the 'gold standard' technique of scintigraphy to quantify gastric emptying (GE) as soon as practicable during an admission with diabetic ketoacidosis (DKA) and following its resolution at least 7 days later.

Research design and methods: Five patients with type 1 diabetes, age 29±12 years; Body Mass Index 23±3 kg/m2; hemoglobin A1c 11.3%±1.9%, were studied during an admission with DKA and following its resolution. Solid and liquid GE were measured using scintigraphy. Solid emptying was assessed via the percentage intragastric retention at 100 min and that of liquid by the 50% emptying time.

Results: There was no difference in either solid or liquid GE at the initial study compared with the follow-up. Median (IQR) solid retention was 47±20 versus 38%±33%, respectively; p=0.31, and time to empty 50% of liquid was 37±25 min versus 35±15 min, p=0.31, at the initial and follow-up GE study, respectively.

Conclusions: GE of solids and liquids is not affected by moderate DKA, inferring that earlier reintroduction of oral intake may be appropriate.

Keywords: Diabetes Mellitus, Type 1; Diabetic Ketoacidosis; Gastric Emptying; Gastroparesis.

MeSH terms

  • Adolescent
  • Adult
  • Diabetes Mellitus, Type 1* / complications
  • Diabetic Ketoacidosis*
  • Gastric Emptying
  • Gastroparesis*
  • Glycated Hemoglobin
  • Humans
  • Young Adult

Substances

  • Glycated Hemoglobin